Should genetic testing be used to set insurance rates?

[jay gw]

WINSTON-SALEM, N.C. – A new study – the largest to date of public attitudes about genetic discrimination – finds that 40 percent of people already undergoing genetic testing are worried that participation might affect their future insurance coverage.

"This study supports the view that public concerns about genetic discrimination are substantial," researchers from Wake Forest University School of Medicine and nine other centers write in the current (May-June 2005) issue of Genetics in Medicine.

The research team, headed by Mark Hall, J. D., reported that 40 percent of the 86,859 participants agreed with the statement: "Genetic testing is not a good idea because you might have trouble getting or keeping your insurance."

http://www1.wfubmc.edu/news/NewsArti...Articleid=1615

[EdipisReks]

i think the idea of genetic profiles being used by insurers is absolutely despicable.

[Rob Lister]

Quote:

Originally posted by EdipisReks
i think the idea of genetic profiles being used by insurers is absolutely despicable.

Why? To think this you must also think that insurance companies in general are despicable (which...given the money I have to pay them monthly, I'd agree)

That's how insurance companies work - by profiling.

It's all about risk assessment.

You can make a law that genetic testing is illegal but why draw the line there? Why not just make a law that an insurance company must charge exactly the same premiums to everyone that applies and must accept all comers no matter what?

[Dancing David]

There are always enviromental factors besides the genetic, the insurance companies would have to consider those as well. Isn't choosing not to treat also more expensive?

[Rob Lister]

Quote:

Originally posted by Dancing David
There are always enviromental factors besides the genetic, the insurance companies would have to consider those as well. Isn't choosing not to treat also more expensive?

They account for those too, as best they can.

[TeaBag420]

Quote:

Originally posted by Dancing David
There are always enviromental factors besides the genetic, the insurance companies would have to consider those as well. Isn't choosing not to treat also more expensive?

Wrong, and No.

Tay-Sachs.

Thank you for playing our game.

[Soapy Sam]

Seems to me there's a dilemma here for the insurers.

The more precisely they can target high risk groups, the fewers customers they leave themselves.

If I get a SuperDNA scan that tells me the probability I will die of ingrown toenails, and my risk is way up there, I may choose to have my toenails removed.
Conversely, if I turn out to be in a low risk group- and therefore insurable- I may decide I don't need the insurance.


Similar constraints apply to any group, whether we talk about car insurance, health insurance etc. The whole point of insurance is to spread the risk among as large a group as possible. If we can precisely pin down the risk, the whole notion of insurance becomes unworkable.

[Chris O.]

Quote:

Originally posted by Soapy Sam

Conversely, if I turn out to be in a low risk group- and therefore insurable- I may decide I don't need the insurance.

Now, I voted "No" immediately upon reading the question. Because I believe random elements can foul up even the most sure predictions.

But I think Soapy brings an interesting point to the argument. If genetics tells me that I do not have the genes for a genetically determined disease, I'm not going to spend much on insurance. Except for the concerns about viral infections, and injury, my future looks fairly bright. Or course even viral infections may be negligable if it turns out I'm genetically predisposed to have a rhobust immune system. So why would I spend money on the off chance that I get hurt? I could see genetic testing causing a major reform in insurance as we know it. If insurance companies insist on only insuring low risk customers (which would be the smart decision) and low risk customers feel no need for insurance, I can envision insurance only being for accidents, much like car insurance is now.

They could genetically test for known disorders, then provide "act of God" insurance for the safe bets. Though, I could see them all going out of business under this system. Because, who honestly believes they're going to die in an accident. That always happens to someone else.

Edited for Spelling

[Chris O.]

Now, what about the injustice to the unfortunate few who are found to be vulnerable to certain disorders by genetic testing?
I think we'd see a national health care plan, covering everyone unable to recieve private health insurance. Much like those [bait] silly communist Canadians [/bait] up north. Of course, everyone would pay for it out of their taxes, but we've got to help our less fortunate fellow citizens. It would lose a lot of money on "bad tips for slow horses" but that's to be expected in a government program.

[Paracelsus]

A twisted discussion from the future...

Insurance company: "It says here that you are very likely to get breast cancer! 89 % to be exact... "
Not the customer: "Well I'm not that likely, because... "
Insurance company: "The genetic screening is accurate... "
Not the customer: "I'm a man, the diagnosis of breastcancer in males is quite rare... so I would consider it highly unlikely... "
IC: "The genetic screening is right and you are wrong Sir!"

[chulbert]

Though I don't like it, I had to vote yes.

I think we're inclined to think the system is unfair because it would "punish" the individual for something that's not their "fault". However, it's not the insurance company's "fault" either that the individual has a genetic propensity for a certain disease. So we're left with a situation in which neither party is at fault but there is a cost involved. Who is responsible for that cost? Ultimately, I think it has to be the individual. Sometimes the universe simply deals you a bad card.

[Kopji]

They should just classify it as 'act of God' and get on with making their 40% profits.

[Rob Lister]

Quote:

Originally posted by Paracelsus
A twisted discussion from the future...

Insurance company: "It says here that you are very likely to get breast cancer! 89 % to be exact... "
Not the customer: "Well I'm not that likely, because... "
Insurance company: "The genetic screening is accurate... "
Not the customer: "I'm a man, the diagnosis of breastcancer in males is quite rare... so I would consider it highly unlikely... "
IC: "The genetic screening is right and you are wrong Sir!"

Then market forces would come into play, just as they will in the case of making genetic testing a requirement. If it is true that this male does not have an 89% chance of developing breast cancer then other companies will see the truth of his lesser risk and see a profit in providing him with lower rates.

This is not to suggest that I think the insurance industry does not require regulation, but I don't think it does as it regards their own internal statistical assessments of risk and how they go about distributing it. I feel confident leaving that part to the market.

[Rob Lister]

Quote:

Originally posted by chulbert
Though I don't like it, I had to vote yes.

I think we're inclined to think the system is unfair because it would "punish" the individual for something that's not their "fault". However, it's not the insurance company's "fault" either that the individual has a genetic propensity for a certain disease. So we're left with a situation in which neither party is at fault but there is a cost involved. Who is responsible for that cost? Ultimately, I think it has to be the individual. Sometimes the universe simply deals you a bad card.

What's worse is when the client has more information about his or her condition than does the company. The reasons for that are obvious.

Genetic testing by insurance companies is going to be a reality in most of our lifetimes, especially as the science of it develops. There is no way around it except to socialize it completely.

I don't know my own genetic condition but I'm willing to bet that I don't want my insurance socialized in that fashion.

Betting is what the business is all about.

[Paracelsus]

Quote:

Originally posted by Rob Lister
This is not to suggest that I think the insurance industry does not require regulation, but I don't think it does as it regards their own internal statistical assessments of risk and how they go about distributing it. I feel confident leaving that part to the market.

Why shouldn't the people that does statistical assement be accredited to do the assesments(much like accountants)? Even today some Insurance companies reject claims or even applications for insurance with "statistics". The individuals doing the rejections are sometimes "impaired" in the field of statistics to say the least. My twisted mock-up conversations is sometimes reality today for some people in other forms.

Genetic screening is a powerful tool and the possibilities for abuse by people with little knowledge in the area are immense. If you look at it genetic screening and assessing the risk takes knowledge of medicin, genetics and statistics. So if it ever allowed for Insurance Companies to do genetic screening of individuals I do believe that the people doing the assesments need to be licensed in some way. Preferably by regulatory law.

[Rob Lister]

Quote:

Originally posted by Paracelsus
Why shouldn't the people that does statistical assement be accredited to do the assesments(much like accountants)? Even today some Insurance companies reject claims or even applications for insurance with "statistics". The individuals doing the rejections are sometimes "impaired" in the field of statistics to say the least. My twisted mock-up conversations is sometimes reality today for some people in other forms.

I think I'm getting your drift but I'm not positive. Your wording was questionable at best. If I got it, the answer is, because it is not necessary for the government to get involved (very much) regulating what market forces so efficiently handle. If they can't do the statistical math then they won't get a market share. Underestimate the risk (reduce premiums) and they lose in the payout. Overestimate the risk (increase premiums) and they can't get the market share. There is a need, and a instance of, regulation in terms of the stats. It has to do with how much escrow the company keeps in terms of potential payouts. It's fairly strict and based on government-fed 'accounting'.

Quote:

Originally posted by Paracelsus
Genetic screening is a powerful tool and the possibilities for abuse by people with little knowledge in the area are immense. If you look at it genetic screening and assessing the risk takes knowledge of medicin, genetics and statistics. So if it ever allowed for Insurance Companies to do genetic screening of individuals I do believe that the people doing the assesments need to be licensed in some way. Preferably by regulatory law.

Has nothing to do with anything, unsupported except by assertion, and a complete strawman from what I can tell. Perhaps I am misreading you however.

[kimiko]

Quote:

Originally posted by chulbert
However, it's not the insurance company's "fault" either that the individual has a genetic propensity for a certain disease.

People have no control over their genes (yet), but insurance companies deliberately chose to go into that business. They are 'at fault' for choosing profit over people.

Quote:

Sometimes the universe simply deals you a bad card.

Lucky us, we live in a society that protects the weak from the strong physically through law and order, so why not do so in business-supplied protections like insurance too?

[Rob Lister]

Huh!?!?!

I read, I furrowed my brows, I thought of visiting Neverland and spending the night with MJ.

Quote:

Originally posted by kimiko
People have no control over their genes (yet), but insurance companies deliberately chose to go into that business. They are 'at fault' for choosing profit...

If you someday choose to open a business, please let me know of its locale so that I can be the first at the door to get my goods for free. I'll sign a statement, if you like, swearing that I really 'need' what I decide to take.

[Shane Costello]

Quote:

Originally posted by EdipisReks:
i think the idea of genetic profiles being used by insurers is absolutely despicable.

That was the attitude my genetics professor took as well. I don't think he went as far as describing genetic profiling for actuarial purposes as being despicable, but he was convinced that insurers wouldn't take into account the complex interaction between environment, lifestyle choice and genetic inheritance that's behind almost all chronic disease.

Quote:

Originally posted by Rob Lister:
Genetic testing by insurance companies is going to be a reality in most of our lifetimes, especially as the science of it develops. There is no way around it except to socialize it completely.

I'm not so sure that genetic profiling is all that close to reality. Take breast cancer. Present scientific knowledge suggests that surprisingly few cases of breast cancer can be primarily attributed to genetic inheritance.

Of course cancer is ultimately a genetic disease, but it's my guess that as medical knowledge increases it'll probably become clear that environmental factors and lifestyle choice are more reliable determinants of future health than genetic inheritance. More to the point, what it'll probably establish is that the vast majority of us are a mixed bag in terms of the genes we inherit. A dispassionate look at my family tree suggests that there's a better than average chance I won't be asking my health insurer for a hair transplant, but that I could well need treatment for glaucoma in middle age. I'd hope that as medical knowledge about the basis of disease increases, so to does the efficiency of treatments, in terms of cost and effectiveness. Genetic profiling might prove to be irrelevant.

[Rob Lister]

Quote:

Originally posted by Shane Costello
Genetic profiling might prove to be irrelevant.

It very well might but I doubt it. The bet here is that you think that the science of meds will advance faster than the science of profiling. I think I'm willing to give you odds on that one. Not great odds. I'll go 1.5:1

But if you're right, you're right. Even if you're wrong (in the short or long term) then there will always be a market niche for the companys that don't bother with any such testing, just as there are morgage companies that don't make you prove your annual/monthly income. It comes at a slightly higher rate but that's the cost of doing that kind of business. More power to them, IMO. More power to the eventual companies they will require a profile too.

[kimiko]

Quote:

Originally posted by Rob Lister
If you someday choose to open a business, please let me know of its locale so that I can be the first at the door to get my goods for free. I'll sign a statement, if you like, swearing that I really 'need' what I decide to take.

Strawman. I believe in a right to healthcare, not a right to anything and everything.

Society replaced a physical law of the jungle for an economic one. Abuse of the weak is no less immoral in one than the other.

[Rob Lister]

Quote:

Originally posted by kimiko
Strawman. I believe in a right to healthcare, not a right to anything and everything.

Society replaced a physical law of the jungle for an economic one. Abuse of the weak is no less immoral in one than the other.

If you socialize health care the health insurance goes away, at least as a private industry. If that's what you want, then fine by me.

What about life insurance? Same industry. Same system. Do you want to socialize that as well? Do they have the right to evaluate your risk using the same variables available to you?

[Paracelsus]

Quote:

Originally posted by Rob Lister
I think I'm getting your drift but I'm not positive. Your wording was questionable at best. If I got it, the answer is, because it is not necessary for the government to get involved (very much) regulating what market forces so efficiently handle. If they can't do the statistical math then they won't get a market share. Underestimate the risk (reduce premiums) and they lose in the payout. Overestimate the risk (increase premiums) and they can't get the market share. There is a need, and a instance of, regulation in terms of the stats. It has to do with how much escrow the company keeps in terms of potential payouts. It's fairly strict and based on government-fed 'accounting'.

Well, you didn't actually catch my drift... It is not about the company it is about the individual doing the assessment. The market forces are strong enough to weed out Insurance Companies that use Astrology to do their assesments because it is about the company as a whole. But if a single individual misreads the numbers with a basis of facts it would be a betting game for the customer. Proper training of the individuals doing the assessments it would help both the companies and the customers of the company.

Quote:

Originally posted by Rob Lister
Has nothing to do with anything, unsupported except by assertion, and a complete strawman from what I can tell. Perhaps I am misreading you however.

Maybe it is a strawman or a misread. All I know of today is the use of Body Mass Index to determine if a person is overweight or underweight when assessing the risk for health insurance. But the interesting thing in this is that a person that has a diet and an excersice plan could be overweight according to the body mass index. All it requires is little to much muscle mass but otherwise a healthy body. But this is just anecdotal evidence of how a single individual in a single company does business. As that it is just a strawman to.

I'm familiar with free market theory, but I wouldn't treat it as "evolution" in the business world. Because I had my own anecdotal evidence where the "free market" does not work. Mostly from my own background in computer software development. Now I'm not taking the discussion of economic theory because it seems that you are more familiar with it than I am and as that I would like to read up on it before a debate it. Right now I don't have the time to read up on it.

[Hellbound]

I was thinking about this yesterday...how would genetic profiling be different from what insurance companies already do?

You are already grouped into categories and your rates set based on that grouping, regardless of your personal habits or nature. For example, if you are older insurance costs are higher, and usually pay less on claims as well. You may be the healthiest 60 year old in the world, it doesn't matter. Likewise, as someone said about body mass index, you may be "overweight" according to body mass index but are actually a professional athlete in excellent shape...doesn't matter. Lokk at car insurance...I may be the most careful and skilled driver in the world...but it makes no difference. I'm male (add to rates), at one time I was 20 years old (add to rates), I might drive a sportier car (add to rates), etc, etc, etc.

I don't see this as becoming some draconian end-all to whether you get insurance or not. First off, I don't believe there will be any large dichotomy between people. Like most other human traits and abilities, your genetic susceptibility will be a bell curve. Any extremes, either to health or illness, will be rare. Most will cluster around a middle. Second, the insurance companies are not stupid (although at times it seems that way). They run a multi-million dollar business. If they start turning away anyone with genetic problems, or raising rates too high, people will go without. If this becomes a common practice, they will have a handful of customers that pay outrageous rates. They'd go out of business.

The final issue is, should we be required to, essentially, subsidize illness? I'm a charitable guy, I donate to various medical groups and such, and I'm one of the first to say I'd like to see everyone get healthcare who needs it (well, almost everyone). However, the question becomes whether it is ethical to be forced to pay for everyone's healthcare (a socialized system or requirements that insurace companies accept everyone at specific rates) regardless of my personal wishes. Genetics is one factor in illness, but environment counts as well. Besides the people who have these illnesses throguh no fault of their own, a scoialized or heavily regulated system will also cover those who, knowing they have a predisposition to certain illnesses, do absolutly nothing in their environment to mitigate that fact. I'd have to pay for the guy with a history of heart disease who decides to eat nothing but bacon sandwiches, and that the walk to the bathroom is daily exercise. I'd also pay for the guy that drinks every day, the drug user that wastes his body for a cheap high, etc, etc, etc. I'm not trying to stereotype people here (I don't think all overweight people are lazy, or anything else), but any socialized system would mean that I'd pay for everyone's healthcare..whether I think they deserve it or not.

I don't believe everyone has a right to healthcare. I think healthcare should be a privaledge open to all, but that you can abuse (and therefore lose) that privaledge.

[Andrea]

The Private healthcare sector in the UK have very stringent policies anyway for new applicants, and with these make it almost impossible to change policies if any treatments are claimed. They will always do almost anything not to pay for long term treatment, or terminally ill patients. Our NHS is in such a poor state, understaffed and under funded, so I could not see where the funds would come from for genetic testing which I do not agree with.

[kimiko]

Quote:

Originally posted by Rob Lister
If you socialize health care the health insurance goes away, at least as a private industry. If that's what you want, then fine by me.

Yes, that's what I would like.

Quote:

What about life insurance? Same industry. Same system. Do you want to socialize that as well? Do they have the right to evaluate your risk using the same variables available to you?

Any insurance that charges people based on qualities they cannot control, like age, sex, race, DNA, is discriminatory. I see no inherent right to personal enrichment based on discrimination. When there are protections for discrimination in other areas of life, it seems strange that it is allowed as the basis of an entire industry. Not every type of insurance has to be socialized; they could merely be legally barred from using discrimination to set rates, and restricted to controllable behaviors as variables.

[kimiko]

Quote:

Originally posted by Huntsman
I don't see this as becoming some draconian end-all to whether you get insurance or not. First off, I don't believe there will be any large dichotomy between people. Like most other human traits and abilities, your genetic susceptibility will be a bell curve.

I see it as a very dangerous thing. I sent inquiries to a number of companies seeking quotes for private health insurance before I was to become ineligible to be covered under my parents' insurance as a dependent. All the forms required info on pre-existing conditions. I have a very rare birth defect not caused by genetics. The result? None of the companies even supplied me with a quote. Oh, several called to clarify the information on the pre-existing condition, and that was all the information they needed to know they wouldn't want me. Because I already have one chronic medical problem, I take very good care of myself otherwise, and have great genes. But that was completely outweighed by something I can do nothing about. It doesn't matter to me how few people would be affected by instituting genetic discrimination, because I know how difficult it makes it for those people.

Quote:

Second, the insurance companies are not stupid (although at times it seems that way). They run a multi-million dollar business. If they start turning away anyone with genetic problems, or raising rates too high, people will go without. If this becomes a common practice, they will have a handful of customers that pay outrageous rates. They'd go out of business.

I doubt there will be legions of people with no susceptibilities in their genetic profile. It might even work to the benefit of companies by exposing predispositions to people who look and feel healthy and wouldn't buy insurance without the fear of future disease. Some will pay exhorbitant prices so a spouse or child with a medical problem or predisposition can get coverage. For the ill, health problems can lead to desperation, and those people will tolerate very high prices as long as they can.

Quote:

Genetics is one factor in illness, but environment counts as well. Besides the people who have these illnesses throguh no fault of their own, a scoialized or heavily regulated system will also cover those who, knowing they have a predisposition to certain illnesses, do absolutly nothing in their environment to mitigate that fact.

You can develop heart disease or diabetes or a myriad lifestyle related diseases without a recognized predisposition, although there may be ones currently unrecognized that will be found in the future. Your point applies to everyone who does anything that can harm their health.

Quote:

I don't believe everyone has a right to healthcare. I think healthcare should be a privaledge open to all, but that you can abuse (and therefore lose) that privaledge.

That's an interesting idea. I'm not sure there is an efficient way to track the health behavior of an entire population- how much and what kind of food/exercise, engaging in risky behavior, etc.

[Shane Costello]

Quote:

Originally posted by kimiko:
Any insurance that charges people based on qualities they cannot control, like age, sex, race, DNA, is discriminatory. I see no inherent right to personal enrichment based on discrimination. When there are protections for discrimination in other areas of life, it seems strange that it is allowed as the basis of an entire industry. Not every type of insurance has to be socialized; they could merely be legally barred from using discrimination to set rates, and restricted to controllable behaviors as variables.

Do you, for instance believe that it's unfair that male motorists under 30 pay higher insurance premiums than female motorists over 50? This is discrimination based on age and gender in action, yet it's hard to argue that the insurance industry isn't justified in doing so given the objective evidence that strongly suggests older women are safer drivers.

Legal restrictions on the ability of insurance companies mightn't be a good idea IMO either. Compelling companies to insure certain groups of people at a loss might only induce them to stop insuring said groups altogether. A more sensible option might be to subsidise these people's insurance premiums.

[Rob Lister]

Quote:

Originally posted by kimiko
Yes, that's what I would like. Any insurance that charges people based on qualities they cannot control, like age, sex, race, DNA, is discriminatory. I see no inherent right to personal enrichment based on discrimination. When there are protections for discrimination in other areas of life, it seems strange that it is allowed as the basis of an entire industry. Not every type of insurance has to be socialized; they could merely be legally barred from using discrimination to set rates, and restricted to controllable behaviors as variables.

Ah. Okay, in your view, a company in the insurance businss cannot discriminate on age, so they must sell a ninety year old life insurance at the same rate as a twenty year old?

[TriangleMan]

Quote:

Originally posted by Paracelsus
Proper training of the individuals doing the assessments it would help both the companies and the customers of the company.

Insurance companies use actuaries for their risk assessments and statistical analysis. In fact that is the primary role of actuaries, although some use their knowledge of statistics for the pension sector rather than insurance. It takes a lot of work and training to become a qualified actuary.

[TriangleMan]

I work in the insurance industry here in Bermuda so may be able to shed some light on how it works. Insurance regulation in the United States is some of the strictest regulation in the world, but it differs from state to state since in the 1930s the Supreme Court ruled that regulation of insurance was a state matter rather than federal. The state regulators have their own National Association to look at current regulatory issues and provide guidance to state regulators on minimum standards for regulation.

Because regulation differs from state to state it is difficult to make general statements about it. Can regulators force insurance companies to sell insurance to people the company would normally consider risky? You bet, but there are interesting ways that State Governments can go about it. In Florida for example the government was finding that many insurers were not selling hurricane insurance to high-risk homeowners. So Florida formed the Citizens Property Insurance Corporation, an insurance company of last resort where people can go for hurricane insurance if the companies won't sell it to them. How is the corporation funded? The Florida government levys a charge on all of the insurance companies who sell hurricane insurance!

Can an insurance company use genetic testing as part of their risk assessment? Short answer is that it probably depends on the state. If you are in the US and are concerned you should send your concerns to your state regulator. The website for the National Association that I linked above will have links to the website for each state's insurance regulator.

[Kevin_Lowe]

Quote:

Originally posted by Rob Lister
If you socialize health care the health insurance goes away, at least as a private industry. If that's what you want, then fine by me.

An alternative is to have socialised and private health care systems side by side. That is what we do in Australia and it seems to work okay.

The problem with current US society is that medical care is so expensive that few can afford to deal with bad-case scenarios without insurance, so insurance is almost a necessity. However this necessity is provided by private corporations that exist to make a profit, and whose policies are sufficiently similar that in cases like Kimiko's they might as well be a monopoly.

That's why I'm in favour of a socialised medical safety net. Access to medical care should not be conditional on whether or not you slip through a gap in corporate policy.

[kimiko]

Quote:

Originally posted by Shane Costello
Do you, for instance believe that it's unfair that male motorists under 30 pay higher insurance premiums than female motorists over 50? This is discrimination based on age and gender in action, yet it's hard to argue that the insurance industry isn't justified in doing so given the objective evidence that strongly suggests older women are safer drivers.

Yes, I think that's unfair. It completely ignores the skills of the individual. GPS tracking systems might be a good way to monitor driving behaviors to tie prices to behavior, but they have privacy issues.

Quote:

Legal restrictions on the ability of insurance companies mightn't be a good idea IMO either. Compelling companies to insure certain groups of people at a loss might only induce them to stop insuring said groups altogether.

Something similar happened in Texas when state regulations about homeowners insurance and mold led to some companies just pulling out of the homeowners market in the state.

Quote:

A more sensible option might be to subsidise these people's insurance premiums.

That might be the best way.

[kimiko]

Quote:

Originally posted by Rob Lister
Ah. Okay, in your view, a company in the insurance businss cannot discriminate on age, so they must sell a ninety year old life insurance at the same rate as a twenty year old?

I started thinking about that when you mentioned it in the previous post, and I'm not really sure. Life insurance seems to be a special case. Health, car, income, homeowners/renters insurance all pertain to the ability of a person to function in society. Life insurance isn't purchased for that person though, it's purchased for others. Obviously, death has to be taken into account since it's a certainty whereas illness, disability, car wrecks, and theft or damage to property are just possibilities. The government has protection in Social Security for the spouses and children of people who die, so there's already a safety net. It seems that makes life insurance much more optional than other types.

[TriangleMan]

Googling "insurance" & "discriminatory" gets a number of interesting links. Here's a summary of a court case on discriminatory practices by an insurance company against AIDS sufferers. The insurance company won.